TKR Dem Dry Bones
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janae
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I will be at 7 weeks in a couple of days. I am wondering how much and how often I should be doing PT. I have not had any PT from a professional since 4 weeks. I would appreciate any advice or input, as I respect my fellow Bonesmarties. Thank you in advance. Also, I can tell a real difference in the pain being much less in the knee. Hooray!!! It is still painful just above knee when rising from a chair, but I do know that gets better with time. Both knees are done now. So thankful.
janae
member
Would appreciate any responses. I am almost 7 weeks out from TRKR, how many times a day and for how many weeks should I be doing PT? Have done on my own since 4 weeks of in home PT. Also, I had a TLKR in May and had never stopped limping before this surgery. Is it possible I will ever be able to walk without limping? I want to SO badly. Thanks in advance for any input.
Josephine
NURSE DIRECTOR EMERITA
Hi there, janae. Sorry I missed your post yesterday but here I am now. I have read your thread right through and see that not only have you had minimal attention from the staff, no-one actually gave you the recovery articles to read! You can find them all in here TKR recovery article compilation. However, there is a couple of articles in particular that pertain to this topic which are these
Activity progression for TKRs
Home physio (PT) and activity progress: suggestions.
I'd also like to ask you some questions which you should answer twice, once for your right knee and again for your left!
1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
3. how often are you icing your knee and for how long?
4. how high are you elevating your leg, how often and for how long?
5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
6. what kind of PT/exercises are you doing? How much and how often?
I'll be back!
Activity progression for TKRs
Home physio (PT) and activity progress: suggestions.
I'd also like to ask you some questions which you should answer twice, once for your right knee and again for your left!
1. what are your pain levels right now?
(remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget that 'pain' also includes soreness, burning, stabbing, throbbing, aching, swelling and stiffness)
2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?
3. how often are you icing your knee and for how long?
4. how high are you elevating your leg, how often and for how long?
5. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and
6. what kind of PT/exercises are you doing? How much and how often?
I'll be back!
janae
member
Thank you Josephine!
RIGHT KNEE:
1. Usually a 3 when sitting. Probably a 5-6 when rising from a sitting position and 4 when walking.
2. I have been prescribed oxycod/apap tab 5-325mg and tramadol hcl tab 50mg. I was allowed 1-2 tablets every 4-6 hrs. I am taking either 2 tabs of the oxy or tramadol (depending on pain) about once a day for the last two weeks. Before that I took more often.
3. I ice multiple times in a 24 hour period depending on pain and sleeplessness. Usually 8 times for 30 minutes. It has cut down this past week as the pain has not been as severe.
4. I elevate my leg in my lift recliner with a king sized pillow placed under it from the top of the thigh down to the ankle (my PT showed me this). I usually am sitting like this unless I am doing PT, waling to bathroom or kitchen or laundry room. I feel very lazy.
5. I have driven several times. I am doing all of the laundry for myself and my husband for the past two weeks. I am helping some with meal preparation. Today I did some sewing for about an hour. Later today, I will be riding for about an hour to have lunch and a visit with our son and then ride an hour back home. A couple of weeks ago I went shopping about an hour from my home, but I rode on the store's electric carts.
6. My PT is walking multiple laps in my house (2700 sq. ft.) so I have a good walking path. I stand at the sink and do 7 different exercises (20 reps) and 8 other exercises while laying or sitting (20 reps). I had been doing them 2 times a day. This past week I have cut down to once a day and have started being more active in my house.
LEFT KNEE :
1. Pain is 0. Once in a while it will feel a little tight or hurt after sleeping.
2. Meds I am taking are for the right knee and are listed above. I was prescribed the same for this one and did not take anything after 3 weeks.
3. I never ice this knee now.
4. It is up in the recliner without the pillow whenever I am elevating the right knee.
5. MY activity level before the right knee surgery had pretty well gotten back to normal for me. House cleaning, meals, laundry and working as a parent educator for Parents As Teachers part time.
6. I don't do any PT on this knee now. I did it faithfully after surgery. The same exercises as I am doing for the right (20 reps twice a day and then 20 reps once a day after 6 weeks for about another 2 weeks).
My left knee has been wonderful, ROM is 135 or more and full extension. The only thing that really upsets me is that I could not walk without limping, so I still used a cane. I really want to walk without limping and be cane free. My PT had me use the cane in my right hand even with my TRKR. The PT seems to think I am still limping because of tissue weakness from my TLHR done in May 2010. I have had 6 infections in that hip since then and am still on a monthly injection of bicillin. My bonescan and 3 aspirations from the hip were all negative for infection. The ID doctor said it is recurring erysipelas.
I just want to know how long to continue PT ( have been on my own since 4 weeks). I have read all of the articles, most more than once! They are so informative and helpful. The PT ones didn't go past 6 weeks. I also would value your opinion on being limp free and cane free.
May God richly bless you for all you do for so many! With sincere thanks.
RIGHT KNEE:
1. Usually a 3 when sitting. Probably a 5-6 when rising from a sitting position and 4 when walking.
2. I have been prescribed oxycod/apap tab 5-325mg and tramadol hcl tab 50mg. I was allowed 1-2 tablets every 4-6 hrs. I am taking either 2 tabs of the oxy or tramadol (depending on pain) about once a day for the last two weeks. Before that I took more often.
3. I ice multiple times in a 24 hour period depending on pain and sleeplessness. Usually 8 times for 30 minutes. It has cut down this past week as the pain has not been as severe.
4. I elevate my leg in my lift recliner with a king sized pillow placed under it from the top of the thigh down to the ankle (my PT showed me this). I usually am sitting like this unless I am doing PT, waling to bathroom or kitchen or laundry room. I feel very lazy.
5. I have driven several times. I am doing all of the laundry for myself and my husband for the past two weeks. I am helping some with meal preparation. Today I did some sewing for about an hour. Later today, I will be riding for about an hour to have lunch and a visit with our son and then ride an hour back home. A couple of weeks ago I went shopping about an hour from my home, but I rode on the store's electric carts.
6. My PT is walking multiple laps in my house (2700 sq. ft.) so I have a good walking path. I stand at the sink and do 7 different exercises (20 reps) and 8 other exercises while laying or sitting (20 reps). I had been doing them 2 times a day. This past week I have cut down to once a day and have started being more active in my house.
LEFT KNEE :
1. Pain is 0. Once in a while it will feel a little tight or hurt after sleeping.
2. Meds I am taking are for the right knee and are listed above. I was prescribed the same for this one and did not take anything after 3 weeks.
3. I never ice this knee now.
4. It is up in the recliner without the pillow whenever I am elevating the right knee.
5. MY activity level before the right knee surgery had pretty well gotten back to normal for me. House cleaning, meals, laundry and working as a parent educator for Parents As Teachers part time.
6. I don't do any PT on this knee now. I did it faithfully after surgery. The same exercises as I am doing for the right (20 reps twice a day and then 20 reps once a day after 6 weeks for about another 2 weeks).
My left knee has been wonderful, ROM is 135 or more and full extension. The only thing that really upsets me is that I could not walk without limping, so I still used a cane. I really want to walk without limping and be cane free. My PT had me use the cane in my right hand even with my TRKR. The PT seems to think I am still limping because of tissue weakness from my TLHR done in May 2010. I have had 6 infections in that hip since then and am still on a monthly injection of bicillin. My bonescan and 3 aspirations from the hip were all negative for infection. The ID doctor said it is recurring erysipelas.
I just want to know how long to continue PT ( have been on my own since 4 weeks). I have read all of the articles, most more than once! They are so informative and helpful. The PT ones didn't go past 6 weeks. I also would value your opinion on being limp free and cane free.
May God richly bless you for all you do for so many! With sincere thanks.
Josephine
NURSE DIRECTOR EMERITA
7 weeks out
Same with the '7 different exercises at the sink' and '8 while laying or sitting'. Can you describe each one you do, please?
And what do you mean by being 'more active' in the house?
Sorry to keep firing questions at you, but it's the only way I can assess the degree of your activity.
You're a bit muddly with your pain meds. Either take one or the other but don't swap them around like that. I suggest you stick with the Tramadol 50mg every 4 hours night and day plus 1,000mg Tylenol with four of the doses, one being the pre-bed time dose.
Ice more. 30mins is no good. What are you using for ice packs? Any time you are resting, elevate and ice as well and throw out the timer!
I suggest you do a little less if you can. Laundry's a tough task if there's much of it and if you have to bend down to get it into and out of the machines. But if you only do it once a week, that would be better!
Honey, the size of your house tells me nothing. I need to know for how long you walk and how many times a day - once, twice?
Same with the '7 different exercises at the sink' and '8 while laying or sitting'. Can you describe each one you do, please?
And what do you mean by being 'more active' in the house?
Sorry to keep firing questions at you, but it's the only way I can assess the degree of your activity.
janae
member
I walk 3-5 times a day in my house, about 5-10 minutes each time. Yesterday I walked outside about a quarter of a mile (it was too much and I really hurt last night)
Standing at sink exercises: once a day
20 heel/toe raises
20 squats
20 standing marching( both legs)
20 rise up on toe, come down on heel and lock out knee
20 standing knee flexion
10 standing hip abduction
10 raise right side up using left hip
30-40ft. side stepping
Laying down exercises: once a day
20 ankle pumps
20 pressing knee into bed
20 heel slides
20 half straight leg raises (pillow under knee)
10 straight leg raises
10 knee extensions using a band on foot to pull
Sitting exercises: once a day
20 lift lower leg up and down
10 heel slides (hold to count of 5)
2 resting heel on chair and letting gravity pull for extension
20 lifting lower leg up and down
By being more active in the house: putting dogs in and out, feeding and watering them
gathering, washing, drying, folding, hanging laundry and putting it away
stripping and helping change sheets on king size bed
helping with some meal preparation
clearing clutter from kitchen table and countertops (don't think hubby sees it there)
putting a few dishes in dishwasher and hand washing a few pans
paying bills and driving to mail them and pick up some meds
Josephine
Standing at sink exercises: once a day
20 heel/toe raises
20 squats
20 standing marching( both legs)
20 rise up on toe, come down on heel and lock out knee
20 standing knee flexion
10 standing hip abduction
10 raise right side up using left hip
30-40ft. side stepping
Laying down exercises: once a day
20 ankle pumps
20 pressing knee into bed
20 heel slides
20 half straight leg raises (pillow under knee)
10 straight leg raises
10 knee extensions using a band on foot to pull
Sitting exercises: once a day
20 lift lower leg up and down
10 heel slides (hold to count of 5)
2 resting heel on chair and letting gravity pull for extension
20 lifting lower leg up and down
By being more active in the house: putting dogs in and out, feeding and watering them
gathering, washing, drying, folding, hanging laundry and putting it away
stripping and helping change sheets on king size bed
helping with some meal preparation
clearing clutter from kitchen table and countertops (don't think hubby sees it there)
putting a few dishes in dishwasher and hand washing a few pans
paying bills and driving to mail them and pick up some meds
Josephine
referee54
Former BoneSmart staff member
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I was going to PT twice a week at this time, and I was going to the gym on Saturdays just to sit in the sauna and do some gentle stretching---I also rode the exercise bike while I was there.
This is pretty much some PT, too!
It is somewhat the same thing that I thought---would I eve lose this pesky limp? It took me about five months or so to lose it.
At six months I made some fine progress---I was at about 80%-85%. At eight months, I was 90%-95%.
So did I!!! I certainly understand how you feel and commiserate with you! you do have to remember, though, that recovery is often longer than we would like it to be, and it is slower than we would like it to be, so just be patient and understand that, while where you are at sounds like a long enough time, it may take months more---mine did, but boy, was it worth it !
janae
member
referee54
Thank you for your response! You said at 7 weeks out you were going to PT twice a week and then the gym on Saturdays. Did you do PT exercises on your own at home daily in addition to that? It is really encouraging that you lost your limp. I am now 5 months out on one knee and 7 weeks on the other. Hopefully by spring, I can walk without the limp. Then I can encourage others as you have me! Thanks for sharing your story.
Thank you for your response! You said at 7 weeks out you were going to PT twice a week and then the gym on Saturdays. Did you do PT exercises on your own at home daily in addition to that? It is really encouraging that you lost your limp. I am now 5 months out on one knee and 7 weeks on the other. Hopefully by spring, I can walk without the limp. Then I can encourage others as you have me! Thanks for sharing your story.
referee54
Former BoneSmart staff member
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No---very little on my own at that time. I may have done some gentle things, like practicing my gait and such, but most of my diligent work was done at the out-patient PT.
I cannot begin to tell you how frustrating it was to worry about when the limp was going to go away. I would start out fairly good in the morning and think"Could this be the BIG DAY?" Then, by 11:00 AM or so, stiffness and such would set in, and the limp would go on and on and on...
Josephine
NURSE DIRECTOR EMERITA
Thank you! That's what I needed.
I walk 3-5 times a day in my house, about 5-10 minutes each time.
Yesterday I walked outside about a quarter of a mile (it was too much and I really hurt last night) Exactly so!So wait a while before you try it again!
Standing at sink exercises: once a day
20 heel/toe raises
20 squats 5 at the most
20 standing marching( both legs)
20 rise up on toe, come down on heel and lock out knee
20 standing knee flexion
10 standing hip abduction
10 raise right side up using left hip
30-40ft. side stepping
Laying down exercises: once a day
20 ankle pumps
20 pressing knee into bed
20 heel slides 10 at most
20 half straight leg raises (pillow under knee) 5 at most but not really necessary if you can do full leg raises
10 straight leg raises 5 at most
10 knee extensions using a band on foot to pull NEVER do this
Sitting exercises: once a day
20 lift lower leg up and down 10 at most
10 heel slides (hold to count of 5) okay so long as it's only to the point of mild discomfort
2 resting heel on chair and letting gravity pull for extension each for 3-5 minutes at the most
20 lifting lower leg up and down 10 at most
By being more active in the house:
putting dogs in and out, feeding and watering them
gathering, washing, drying, folding, hanging laundry and putting it away
stripping and helping change sheets on king size bed ...... helping who? hubby?
helping with some meal preparation
clearing clutter from kitchen table and countertops (don't think hubby sees it there)
putting a few dishes in dishwasher and hand washing a few pans
paying bills and driving to mail them and pick up some meds
I've amended some of your exercises. For 7 weeks out, you are doing far too much and I've suggested amendments ...
I walk 3-5 times a day in my house, about 5-10 minutes each time.
Yesterday I walked outside about a quarter of a mile (it was too much and I really hurt last night) Exactly so!So wait a while before you try it again!
Standing at sink exercises: once a day
20 heel/toe raises
Laying down exercises: once a day
20 ankle pumps
20 pressing knee into bed
Sitting exercises: once a day
10 heel slides (hold to count of 5) okay so long as it's only to the point of mild discomfort
2 resting heel on chair and letting gravity pull for extension each for 3-5 minutes at the most
By being more active in the house:
putting dogs in and out, feeding and watering them
gathering, washing, drying, folding, hanging laundry and putting it away
stripping and helping change sheets on king size bed ...... helping who? hubby?
helping with some meal preparation
clearing clutter from kitchen table and countertops (don't think hubby sees it there)
putting a few dishes in dishwasher and hand washing a few pans
paying bills and driving to mail them and pick up some meds
I've amended some of your exercises. For 7 weeks out, you are doing far too much and I've suggested amendments ...
referee54
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Hey could yo take a look at this article:
Where are you in recovery?? (tkr)
You are at seven weeks, and, while it seems like enough time, you are still in the "pre-game warm-up" section of recovery, and the truth be told, you still have quite a ways to go.
Slow down, cut back on what you are doing, be patient, and understand that you will arrive at the destination of being totally healed and recovered, bu it will most likely take longer than you would like it to.
Where are you in recovery?? (tkr)
You are at seven weeks, and, while it seems like enough time, you are still in the "pre-game warm-up" section of recovery, and the truth be told, you still have quite a ways to go.
Slow down, cut back on what you are doing, be patient, and understand that you will arrive at the destination of being totally healed and recovered, bu it will most likely take longer than you would like it to.
janae
member
Josephine and referee54, Thank you so much for your time, advice and input! I think perhaps I have been a little too aggressive with the pt. I don't want to regress, but I certainly don't want to cause unnecessary swelling and pain either. I will back off as suggested.
janae
member
Now at 8 weeks. I am afraid maybe I am just getting lazy! In my mind I think about the things I want to do and think I can, and the reality is that I don't get them done. I thought I could go back to work part time at six weeks and I still have not. I am now thinking about getting my house deep cleaned for Thanksgiving and what all I need to cook. My reality is that I have done none of it. I always make a huge homemade meal for 7 adults. I make everything from scratch-turkey, broth ,noodles, gravy, mashed potatoes, gravy, sweet potato casserole, green beans, cranberry salad, deviled eggs, veggie tray with dip, hot rolls, pecan pie, pumpkin pie, fresh whipped cream and iced tea. I also make big breakfasts, and other meals throughout the weekend for everyone. I am afraid maybe this is still too much for me. Is this doable or am I just getting lazy?
Josephine
NURSE DIRECTOR EMERITA
This is your Christmas off this year! You're definitely not ready for all that at 8 weeks. You wouldn't be ready for it at 12 weeks. You probably would find it a challenge at 16 weeks. Organise the 'troops' (your guests) to get it all done for you. Hand out different dishes for people to cook and bring with them. And when they all come, organise the men to lay table, clear up and do the washing up! As for you, you just sit and organize everyone else!
referee54
Former BoneSmart staff member
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Yes, I agree with your assessment.
I believe sincerely that, if you cut back you will actually find more progress and less swelling and stiffness; hence, you will gently achieve more ROM. Do not be in a hurry.
janae
member
Josephine, Oh my! I think I want you to come live with me.
I'm trying not to feel guilty for not being supermom. I went with my husband and daughter to Sam's Club and rode the electric cart. We purchased most everything premade (just reheat and serve) for our Thanksgiving day and weekend meals. I'll just have a few things to make from scratch. I will let the others help with the work involved of meals and cleanup. My husband and I did get the house cleaned over the weekend. He has been AWESOME!!! This will probably be good for me and my family. I will learn that we can have great holidays without exhausting myself, and they will learn how to share the responsibilities. Thanks so much for the support and advice. May you be blessed many times over!
I'm trying not to feel guilty for not being supermom. I went with my husband and daughter to Sam's Club and rode the electric cart. We purchased most everything premade (just reheat and serve) for our Thanksgiving day and weekend meals. I'll just have a few things to make from scratch. I will let the others help with the work involved of meals and cleanup. My husband and I did get the house cleaned over the weekend. He has been AWESOME!!! This will probably be good for me and my family. I will learn that we can have great holidays without exhausting myself, and they will learn how to share the responsibilities. Thanks so much for the support and advice. May you be blessed many times over!janae
member
referee54, As advised, I have cut way back on the PT. I am only doing the ones Josephine advised once a day. It has not seemed to hurt my ROM at all and actually my extension seems improved. I still have thigh pain and pain upon rising from a sitting position. I do know from the knee I had done 6 months ago that it will get better. I think it is taking longer due to not being able to take anti-inflammatory meds. Thank you for your help.
Josephine
NURSE DIRECTOR EMERITA
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